Ophthalmology and Therapy最新文献

{"title":"Low-Concentration Atropine for Myopia Management: Recent Evidence and Clinical Implications.","authors":"Imran Jawaid, Carla Lanca","doi":"10.1007/s40123-026-01466-2","DOIUrl":"10.1007/s40123-026-01466-2","url":null,"abstract":"<p><p>We conducted a narrative review of peer-reviewed randomized controlled trials (RCTs) investigating low-concentration atropine for myopia management. Studies were identified using the terms \"myopia\" AND \"atropine\" and supplemented through reference searches. Key data on spherical equivalent refraction (SER), axial length (AL) progression, participant demographics, and ethnicity were extracted and qualitatively compared across trials. In addition, observed AL progression was contextualized against expected age-matched myopic axial elongation and physiological emmetropic eye growth derived from previously published normative models. Evidence from pivotal trials such as ATOM and LAMP, mainly conducted in Asian populations, demonstrated dose-dependent efficacy of atropine, with 0.05% showing superior outcomes compared with 0.01%. However, more recent studies in non-Asian populations, including STAR, MOSAIC, WA-ATOM, and MTS, have reported more modest treatment effects with 0.01% atropine. Differences in efficacy appear influenced by factors including age, ethnicity, baseline progression rates, environmental exposures, and placebo-group axial elongation rates. The coronavirus disease 2019 (COVID-19) pandemic also impacted outcomes in several trials, highlighting environmental influences on myopia progression. In addition, off-protocol use of myopia-control interventions in studies such as CHAMP further complicates interpretation of atropine efficacy. While low-concentration atropine remains a promising option for myopia management, rebound progression after cessation remains a concern. Emerging evidence suggests that future research should look at higher atropine concentrations, individualized treatment strategies, and comparisons against normative ocular growth trajectories rather than placebo alone. Licensed atropine formulations, particularly within Europe, are anticipated to improve treatment standardization, support regulatory oversight, and help refine future clinical guidelines for myopia management.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3203-3219"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Individualized Office-Based Vision Therapy for Intermittent Exotropia: A Retrospective Cohort Study.","authors":"Xinyuan Pan, Ziang Yin, Huina Zhang, Wesley T Beaulieu, Jinyou Zou, Zhikuan Yang, Susan A Cotter, Xiaoning Li","doi":"10.1007/s40123-026-01455-5","DOIUrl":"10.1007/s40123-026-01455-5","url":null,"abstract":"<p><strong>Introduction: </strong>Vision therapy (VT) has been proposed as a nonsurgical treatment option for intermittent exotropia (IXT), although evidence regarding the optimal treatment dosage remains limited. This study aims to investigate the relationships between VT dosage and baseline demographic and clinical characteristics of treatment outcomes in IXT.</p><p><strong>Methods: </strong>Patients with IXT who underwent office-based VT between July 2020 and March 2024 at Changsha Aier Eye Hospital were included. Treatment outcome was classified as functional recovery (yes/no), defined by prespecified thresholds for fusion on the Worth Dot test (33 cm, 1 m, and 3 m), stereoacuity (distance and near), and convergence amplitudes. Binary logistic regression was used to evaluate associations between baseline characteristics and VT dosage on treatment outcomes. The Benjamini-Hochberg procedure was used to adjust P values and maintain the false discovery rate at 5%.</p><p><strong>Results: </strong>Among 636 patients, 296 (46.5%) achieved functional recovery (38.5% in the ten-session group, 46.5% in the 20-session group, and 52.9% in the ≥ 30-session group). After adjustment for baseline fusion status, stereoacuity, and convergence amplitudes, each additional ten VT sessions was associated with a 5% increase in the odds of functional recovery (odds ratio, OR = 1.05, 95% CI 1.02-1.07; P = 0.003). Patients with better baseline Worth Dot fusion at 3 m were more likely to meet recovery criteria (OR = 1.28 per 1-point increase, 95% CI 1.12-1.48; P < 0.001). Moreover, worse baseline stereoacuity at near (OR = 0.43 per 1-log10 arcsec increase, 95% CI 0.30-0.62; P < 0.001) and far (OR = 0.12 per 1-log10 arcsec increase, 95% CI 0.06-0.23; P < 0.001) were associated with a reduced likelihood of functional recovery. Age, gender, treatment frequency, baseline Worth Dot at 33 cm or 1 m, and baseline convergence amplitudes were not associated with outcomes. Significant improvements were observed for nearly all measured clinical parameters.</p><p><strong>Conclusions: </strong>Office-based VT was associated with functional recovery in patients with IXT, with greater gains in those who received more therapy sessions and had better baseline binocular function. Prospective, randomized trials are needed to confirm these findings.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3363-3377"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced Macular Imaging Referral Pathway: Bridging Community Optometrists and Hospital Specialists for Smarter Eye Care.","authors":"Serena Salvatore, Josh Harvey, Amy Hughes, Lisa Gibson, John Hopcroft, Sarah Swift, James Marsterson, Clare Bailey","doi":"10.1007/s40123-026-01477-z","DOIUrl":"10.1007/s40123-026-01477-z","url":null,"abstract":"<p><strong>Introduction: </strong>Hospital eye services in England face sustained demand, with nearly 9 million outpatient appointments in 2023-2024. Teleophthalmology pathways that combine community-acquired imaging with hospital virtual review may reduce unnecessary face-to-face visits. We evaluated an enhanced macular imaging referral pathway linking community optometry optical coherence tomography (OCT) and colour fundus imaging with hospital-led teleophthalmology review.</p><p><strong>Methods: </strong>We performed a retrospective service evaluation of 376 consecutive adult macular referrals received at University Hospitals of Bristol and Weston, between July 2024 and March 2025. Community optometrists submitted bilateral macula-centred 45° colour fundus photographs, bilateral OCT volume scans in digital imaging and communications in medicine (DICOM) format and clinical data via a secure platform. Referrals were reviewed by a consultant ophthalmologist or hospital optometrist within 1 working day. Under the previous pathway, all accepted referrals required an initial face-to-face hospital appointment. Primary outcomes were referral appropriateness, avoided hospital appointments and redirection to other sub-specialties; secondary outcomes were management decision and diagnostic category. Analyses were descriptive.</p><p><strong>Results: </strong>Median age was 74 years (IQR 14); 54.3% were female. Overall, 327/376 referrals (87.0%, 95% CI 83.2-90.0) were appropriate for macular assessment. Of the referrals, 49 (13.0%) were inappropriate because of incomplete imaging (n = 18, 4.7%) or redirection to another sub-specialty (n = 31, 8.2%), most commonly vitreoretinal services (n = 27, 7.2%). Among appropriate referrals, 241/327 (73.7%, 95% CI 68.7-78.2) avoided the mandatory first hospital visit required under the previous pathway. Management outcomes across the cohort were: neovascular age-related macular degeneration (nAMD) pathway, 17.1%; redirection, 6.1%; discharge to community, 10.2%; virtual follow-up, 15.3%; and face-to-face appointment, 51.2%. Mean time to treatment for nAMD was 8.6 days (95% CI 6.0-11.2 days).</p><p><strong>Conclusions: </strong>This teleophthalmology-enabled macular referral pathway achieved high referral appropriateness and substantially reduced mandatory first-visit hospital appointments while supporting timely treatment for sight-threatening macular disease. The model appears scalable and may help National Health Service hospital eye services manage rising demand more efficiently.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3305-3315"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Faricimab Improves Choriocapillaris Perfusion in Diabetic Macular Edema.","authors":"Soo Young Lee, Jounghan Kim, Ye Eun Han, Junyeop Lee","doi":"10.1007/s40123-026-01485-z","DOIUrl":"10.1007/s40123-026-01485-z","url":null,"abstract":"<p><strong>Introduction: </strong>This study is a retrospective observational study to evaluate the effects of intravitreal faricimab on choriocapillaris perfusion in diabetic macular edema (DME) using optical coherence tomography angiography (OCTA) and to investigate the relationship between changes in choriocapillaris flow void (CCFV) and visual outcomes.</p><p><strong>Methods: </strong>Eyes with center-involved DME that received four consecutive monthly intravitreal faricimab injections were included. OCTA (Solix FullRange®) was obtained within 1 month before the first injection and 1 month after the fourth injection. The choriocapillaris (CC) slab was segmented per device default, and CCFV was quantified after Phansalkar local thresholding. Additional metrics included central retinal thickness (CRT), subfoveal choroidal thickness (sfChT), and choroidal vascularity index in Sattler's (CVI_S) and Haller's layers (CVI_H). Pre/post differences were tested with paired t-tests, and Pearson correlation analyses were performed to assess the associations of changes in CCFV with changes in structural optical coherence tomography (OCT) parameters and best-corrected visual acuity (BCVA).</p><p><strong>Results: </strong>Thirty eyes were analyzed. Mean CCFV decreased from 53.35 to 48.89%, yielding a mean reduction of 4.46% (95% confidence interval [CI], -6.37 to -2.56; P < 0.001). BCVA improved significantly (mean difference, -0.20 logMAR; 95% CI -0.27 to -0.12; P < 0.001). CRT decreased from 483.43 ± 72.26 to 313.93 ± 58.41 µm (mean difference, -169.50 µm; P < 0.001). sfChT also decreased significantly (mean difference, -35.56 µm; P < 0.001). CVI_H increased significantly (mean difference, 2.71 percentage points; P < 0.001), whereas CVI_S showed a slight but non-significant increase (mean difference, 0.62 percentage points; P = 0.483). No significant correlations were observed between changes in CCFV and those in CRT, sfChT, CVI_S, or CVI_H (all P > 0.05). However, changes in CCFV were positively correlated with changes in BCVA (r = 0.437, 95% CI 0.091-0.689; P = 0.016), with greater reductions in CCFV associated with greater visual acuity improvement.</p><p><strong>Conclusions: </strong>Faricimab was associated with a significant reduction in CCFV, suggesting improved choriocapillaris perfusion accompanied by significant anatomical and functional improvements in DME. The significant association between changes in CCFV and visual acuity improvement suggests that OCTA-derived CCFV may serve as a functional biomarker of treatment response. These findings support the concept that restoration of choriocapillaris perfusion may contribute to visual recovery and highlight the role of the choroid in DME beyond retinal edema resolution.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3529-3545"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy of Topical Eye-Drop Regimens for Dry Eye After Cataract Surgery: A Systematic Review and Network Meta-analysis.","authors":"Boyang Song, Yukang Li, Chengfei Liu, Zhaojiang Du","doi":"10.1007/s40123-026-01484-0","DOIUrl":"10.1007/s40123-026-01484-0","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative dry eye can impair visual recovery and patients' perceived benefit after cataract surgery. We compared topical eye-drop regimens across tear-film stability, tear secretion, corneal epithelial damage, and patient-reported symptoms.</p><p><strong>Methods: </strong>A PROSPERO-registered review searched nine databases from inception to January 30, 2026, for randomized trials of ocular-surface treatments after cataract surgery. Frequentist random-effects network meta-analyses assessed 1-month tear-film breakup time, Schirmer test, corneal fluorescein staining, and Ocular Surface Disease Index; safety was summarized descriptively.</p><p><strong>Results: </strong>Forty-seven trials (102 arms; 4920 eyes assessed; 4844 arm-level analyzed observations) were included; 38 trials (81 arms; 3898 analysis units) contributed to network meta-analyses within a 19-node framework. Compared with routine postoperative care, moderate-confidence evidence indicated greater tear-film breakup time with diquafosol plus hyaluronic acid (mean difference 4.17 s, 95% confidence interval 1.99-6.35) and cyclosporine plus carboxymethylcellulose (3.97 s, 1.60-6.34), whereas low-confidence evidence suggested a possible increase with cyclosporine plus deproteinized calf blood extract (4.98 s, 1.93-8.03). Outcome-specific benefits were observed for tear secretion and corneal staining, whereas symptom findings were exploratory. Most top-ranked treatment nodes across the four networks were informed by only one or two trials with few analysis units. Some estimates were affected by high risk of bias or local incoherence. No statistically significant global inconsistency was detected overall.</p><p><strong>Conclusions: </strong>No single topical regimen showed consistently favorable effects across all postoperative ocular-surface outcomes. Outcome-specific signals require confirmation because sparse direct evidence, risk of bias, and limited safety and longer-term data preclude definitive recommendations. Adequately powered head-to-head trials with standardized postoperative care are needed for future clinical guidance.</p><p><strong>Trial registration: </strong>PROSPERO CRD42026138249.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3245-3272"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Prospective Evaluation of the 2-Year Efficacy and Safety of INTERCIL: A Novel Uveal Spacer for Open-Angle Glaucoma.","authors":"Lilit Voskanyan, Vahan Papoyan, Hayk Babayan, Hovsep Miroyan, Christophe Baudouin","doi":"10.1007/s40123-026-01469-z","DOIUrl":"10.1007/s40123-026-01469-z","url":null,"abstract":"<p><strong>Introduction: </strong>Intraocular pressure (IOP) reduction is the most commonly therapeutically modifiable risk factor in glaucoma. Minimally invasive glaucoma surgeries are generally considered safe but ineffective, constrained by physiological pressure. Invasive bleb-forming filtration surgeries are effective, but associated with high risk and high rates of failure. Technologies utilizing uveoscleral rely on creation of a cyclodialysis cleft. This study evaluated a novel supraciliary uveal spacer (INTERCIL^®) designed to enhance uveoscleral outflow, avoiding anterior and posterior chamber entry or bleb formation.</p><p><strong>Methods: </strong>SAFARI 3, a prospective, single-center, single-arm study included adults with mild-to-moderate glaucoma (Shaffer grade 1-4), uncontrolled on 1-4 medications (baseline IOP 21-35 mmHg). Patients underwent standalone ab externo implantation of INTERCIL^®. The primary endpoint was mean change in medicated IOP at 24 months. Secondary outcomes included medication reduction, success rates (IOP ≤ 18 mmHg with ≥ 20% reduction), safety, and quality of life.</p><p><strong>Results: </strong>Twenty-nine patients with primary open-angle glaucoma (POAG) were analyzed (mean age 65.9 years; baseline IOP 23.4 ± 1.9 mmHg; medications 1.9 ± 0.9). At 24 months (n = 19), mean IOP decreased to 14.4 ± 3.1 mmHg (39% reduction); medication use decreased to 0.4 ± 0.8 (83% reduction), with 73.7% medication-free. Complete and qualified success rates were 74% and 95%, respectively. All patients achieved ≥ 20% IOP reduction by 12 and 24 months; 94.7% had IOP between 6 and 18 mmHg at 24 months. Adverse events were mild to moderate in severity. One event of inadvertent anterior chamber entry with migration affected one patient. Six cases of cataract, not deemed device- or procedure-related, were reported; causality cannot be excluded, but cataract development is not uncommon after glaucoma surgery. Device position remained stable overall, and visual function parameters showed no clinically significant changes.</p><p><strong>Conclusions: </strong>INTERCIL^® provided sustained IOP and medication reduction by potentially harnessing uveoscleral outflow, without surgical risks associated with bleb- or cleft- dependent procedures, suggesting a potential new concept for patients with open-angle glaucoma requiring durable disease control.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier, NCT05236439.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3379-3399"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wnt Pathway Agonism as a Therapeutic Strategy for Retinal Vascular Diseases: A Narrative Review of Evidence to Date.","authors":"Stephane Angers, Charles C Wykoff, David A Antonetti, Harald J Junge, Eric Nudleman, Aaron Nagiel, Patricio G Schlottmann, Donald J D'Amico, Jonathan Prenner, David R Guyer, Charles G Miller, Keith Baker, Paul Stephens, Erin Henry, Hans Rekers, Anthony P Adamis, Yin Shan Eric Ng","doi":"10.1007/s40123-026-01476-0","DOIUrl":"10.1007/s40123-026-01476-0","url":null,"abstract":"<p><p>Breakdown of the blood-retinal barrier (BRB) is implicated in many blinding retinal diseases, including diabetic macular edema, neovascular age-related macular degeneration, and retinal vein occlusion. Anti-vascular endothelial growth factor (anti-VEGF) therapies or laser photocoagulation are currently the standard of care for retinal diseases that are characterized by breakdown of the vascular barrier function and vascular hyperpermeability. However, inadequate response to anti-VEGF therapy is seen in a substantial proportion of patients and laser photocoagulation does not restore vision loss and can lead to collateral damage of the retina. Thus, new therapeutic targets are needed. The β-catenin-dependent wingless-related integration site (Wnt) signaling pathway plays a critical role in inner BRB development and maintenance. There are several potential therapeutics for retinal vascular diseases targeting the Wnt/β-catenin pathway under investigation, including several in preclinical development and one (MK-3000; also known as Restoret and formerly EYE103) with early clinical trial results advancing to late-stage clinical development. In this narrative review we examine the role of Wnt/β-catenin signaling in inner BRB maintenance and in retinal vascular diseases, as well as the potential for Wnt pathway agonism as a therapeutic approach.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3225-3243"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Orbital Decompression and Rectus Muscle Myectomy for Large-Angle Strabismus in Thyroid-Associated Orbitopathy.","authors":"Meng-Wei Hsieh, Lung-Chi Lee, Chia-Chen Hsu, Hsu-Chieh Chang, Yi-Hao Chen, Ke-Hung Chien","doi":"10.1007/s40123-026-01479-x","DOIUrl":"10.1007/s40123-026-01479-x","url":null,"abstract":"<p><strong>Introduction: </strong>Thyroid-associated orbitopathy (TAO) often causes restrictive strabismus and diplopia. Large-angle deviations pose particular challenges owing to extraocular muscle fibrosis and unpredictable surgical dose-response. Although combined orbital decompression and strabismus correction has been proposed to reduce the number of procedures, its effectiveness in large-angle TAO remains uncertain. This study aimed to evaluate the outcomes of combined orbital decompression and rectus muscle myectomy in this population.</p><p><strong>Methods: </strong>In this retrospective cohort study, 88 patients with TAO-associated strabismus > 25 prism diopters (PD) underwent either staged (step) surgery (n = 42) or combined surgery (n = 46) at a tertiary center between 2018 and 2022. All had stable thyroid function for ≥ 6 months before surgery. The combined procedure involved simultaneous orbital decompression and rectus myectomy. Outcomes included deviation angles, Hertel exophthalmometry, and the field of binocular single vision (BSV).</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups. Postoperatively, the combined-surgery group had smaller residual horizontal and vertical deviations-median 0 (0-3) and 2 (0-3) PD-than the step group, 5 (4-5) and 3 (3-5) PD (all p < 0.001). The BSV field was wider after combined surgery [410 (396-426)° versus 360 (328-386)°, p < 0.001]. Overall success rates (≤ 5 PD deviation in primary and reading positions) were similar (84.8% versus 81.0%, p = 0.633). Transient lower lid retraction occurred in a few patients and was successfully corrected.</p><p><strong>Conclusions: </strong>Combined orbital decompression with rectus myectomy achieved effective alignment and superior binocular function compared with staged surgery, offering a practical and safe option for TAO-related large-angle strabismus.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3515-3528"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Modeling of Coronary Artery Disease Using Color Fundus Photography-Based Features of Retinal Vasculature.","authors":"Natasa Jeremic, Emese Sükei, Azin Zarghami, Michael Apata, Meltem Esengönül, Maximilian Pawloff, Andreas Pollreisz, Reinhard Windhager, Matthias Hasun, Alexander Niessner, Stefan Sacu, Hrvoje Bogunovic, Ursula Schmidt-Erfurth","doi":"10.1007/s40123-026-01444-8","DOIUrl":"10.1007/s40123-026-01444-8","url":null,"abstract":"<p><strong>Introduction: </strong>Coronary artery disease (CAD) remains the leading cause of death and current screening methods are limited. Color fundus photography (CFP) has been explored in literature mostly on the basis of associations and exploratory deep learning approaches with only indirect end points. In this explorative study, we aimed to assess the predictive abilities and limitations of explainable CFP-based features using machine learning and same-visit coronary angiography (CA) outcomes as end points for the first time.</p><p><strong>Methods: </strong>Patients undergoing CA were imaged with CFP (Zeiss Clarus 500, Zeiss, Oberkochen, Germany) during the same visit. Coronary plaque burden was assessed using the Gensini Score. Retinal features were extracted using Automorph. Machine learning models were trained and evaluated using fivefold cross-validation. Shapley additive explanations (SHAP) values quantified feature importance and interactions.</p><p><strong>Results: </strong>Of 977 screened patients, 632 (1293 eyes) were assessed. CFP features alone reached moderate predictive performance (area under the receiver operating characteristic (AUROC) 0.692). Adding dimensionally reduced CFP features to clinical baselines consistently improved performance, with the best configuration yielding an AUROC 0.775, average precision (AP) 0.752, and Brier score 0.203. Net reclassification improvement (NRI)/integrated discrimination improvement (IDI) analyses supported improved reclassification for age + sex and basic clinical baseline models, but not for extended clinical baseline models. SHAP analysis revealed vessel width, density, and tortuosity as important vascular retinal indicators of CAD burden. Interaction analysis revealed nonlinear, age-, sex-, and diabetes-dependent effects.</p><p><strong>Conclusions: </strong>CFP features modestly improved the CAD classification beyond clinical baselines. Our findings illustrate the potential and the limitations of CFP features and indicate the need for complex modeling, methodological improvement, and multimodal approaches to achieve valuable classification efficacy.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3009-3024"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photodynamic Therapy in Central Serous Chorioretinopathy: Treatment Timing, Anatomical Response, and Recurrence in a Large Real-World Cohort.","authors":"Caroline M Stüven, Tina Herold, Paul Foerster, Julian Klaas, Jakob Siedlecki, Siegfried G Priglinger, Leonie F Keidel, Benedikt Schworm","doi":"10.1007/s40123-026-01462-6","DOIUrl":"10.1007/s40123-026-01462-6","url":null,"abstract":"<p><strong>Introduction: </strong>Central serous chorioretinopathy (CSC) is characterized by pathological accumulation of subretinal fluid (SRF), leading to visual impairment. Photodynamic therapy (PDT) is an established treatment for chronic or persistent CSC. This study aimed to identify predictors of treatment response in a large cohort of patients with CSC treated with PDT.</p><p><strong>Methods: </strong>In this retrospective, single-center study, clinical characteristics and treatment outcomes of patients with CSC undergoing PDT were systematically analyzed. Central retinal thickness (CRT) and visual acuity were assessed before and after treatment. The interval between initial diagnosis and PDT was evaluated for its impact on therapeutic response.</p><p><strong>Results: </strong>A total of 115 patients (90 males, 25 females; mean age 49.95 ± 10.15 years) were included. The mean interval from diagnosis to PDT was 3.79 ± 3.53 years. CRT decreased significantly following PDT (p < 0.001), with complete SRF resolution in 51.3% of eyes. Mean visual acuity improved by -0.02 ± 0.22 logMAR (p = 0.0047). Recurrence occurred in 30% of eyes after a mean of 1.1 ± 1.1 years. A significant negative correlation was observed between time to PDT and CRT reduction (r = -0.286, p = 0.001) but not with visual acuity (p = 0.76). Repeat PDT, performed in 16 eyes, resulted in further significant CRT reduction (p = 0.008).</p><p><strong>Conclusions: </strong>PDT is effective in reducing SRF in CSC. Delayed treatment was associated with diminished anatomical response. Repeat PDT may provide additional benefit in recurrent disease.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3089-3100"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148606082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}